摘要
目的:探讨单肺通气时体位对肺力学的影响。方法:12例胸科手术病人,分别于仰卧位双肺通气后、仰卧位单肺通气后、侧卧位双肺通气后及侧卧位单肺通气后,记录病人的肺力学参数及动脉血气。结果:从仰卧位转为侧卧位后,最大吸气压(PIP)明显上升,动态肺顺应性(Cdyn)明显下降,加上单肺通气后,上述参数变化更为明显。仰卧双通时,PEEPi未测出,而仰卧位单通时,PEEPi约为1 cm H_2O,侧卧单通时,上升为3 cm H_2O。体位对动脉血气无明显影响。结论:侧卧位后,PIP及cdyn明显改变,侧卧单通时出现PEEPi,对于原本就可能存在有PEEPi的病人,加上PIP升高,有引起肺泡破裂的危险。
Purpose: To explore the effects of different posture on pulmonary mechanics during one-lung ventilation. Methods: Twelve thoracic operation cases were enrolled in this study. The pulmonary mechanics parameters and the artery blood gas results were recorded during supine with two-lung vantilation(TLV) , supine with one - lung ventilation (OLV) , lateral posture with TLV and lateral posture with OLV respectively. Results: The peak inspiratory pressure(PIP) was significantly increased, and the dynamic pulmonary compliance (Cdyn) was significantly decreased during posture changes from supine to lateral posture. The above parameters were changed more if with OLV. The intrinsic PEEP( PEEPi) was gradually increased during posture changes form supine to lateral posture or from TLV to OLV. Posture changes did not affect artery blood gas results. Conclusion: Posture changes affected pulmonary mechanics. Attention should be paid to patients with poor pulmonary mechanics during lateral posture with OLV.
出处
《临床急诊杂志》
CAS
2003年第5期8-9,共2页
Journal of Clinical Emergency
